破裂动脉瘤的八代人中改善的结果:在审判后的第二个十年里,内血管治疗作为第一个拒绝的权利
Li Ma1, Samer S Hoz1, Alhamza R Al-Bayati2
1Department of Neurological Surgery, University of Pittsburgh Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
World neurosurgery
|August 12, 2024
概括
患有肺动脉瘤下arachnoid出血 (aSAH) 的八岁人群的结果正在改善,内血管治疗是主要的方法. 预后取决于基线功能和并发症,而不仅仅是亨特-赫斯等级.
科学领域:
- 神经外科 神经外科
- 干预神经病学 干预神经病学
- 老年医学 老年医学
背景情况:
- 历史上,患有动脉瘤下关节出血 (aSAH) 的八分生病患者的治疗结果较差.
- 血管内技术的进步促使重新评估这一年龄组的结果.
研究的目的:
- 在基准试验 (ISAT/BRAT) 后的第二个十年中评估八十多岁的aSAH患者的治疗结果.
- 确定影响该人口死亡率和功能恢复的因素.
主要方法:
- 针对80岁及以上患者的单中心aSAH数据库的回顾性审查.
- 评估死亡率和有利的神经结果 (修改的兰金尺度<3) 与子组分析.
主要成果:
- 八代人代表了aSAH队列的6%;21%的人有高度 (亨特-赫斯4-5) 出血.
- 在90%的病例中使用了内血管治疗. 平均17个月的随访后,总死亡率为39%.
- 53%的患者获得了有利的神经结果;结果受到亨特-赫斯等级和基线功能状态的显著影响.
结论:
- 八岁以上的aSAH患者的神经结果正在改善,主要是由于增加了内血管治疗的使用.
- 亨特-赫斯等级,基线功能状态和并发症对于八十岁的aSAH患者的预后至关重要.
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